Potential causal links and mediation pathway between urban greenness and lung cancer mortality: Result from a large cohort (2009 to 2020).

Urban greenness, as a vital component of the urban environment, plays a critical role in mitigating the adverse effects of rapid urbanization and supporting urban sustainability. However, the causal links between urban greenness and lung cancer mortality and its potential causal pathway remain poorly understood. Based on a prospective community-based cohort with 581,785 adult participants in southern China, we applied a doubly robust Cox proportional hazard model to estimate the causal associations between urban greenness exposure and lung cancer mortality. A general multiple mediation analysis method was utilized to further assess the potential mediating roles of various factors including particulate matter (PM1, PM2.5-1, and PM10-2.5), temperature, physical activity, and body mass index (BMI). We observed that each interquartile range (IQR: 0.06) increment in greenness exposure was inversely associated with lung cancer mortality, with a hazard ratio (HR) of 0.89 (95 % CI: 0.83, 0.96). The relationship between greenness and lung cancer mortality might be partially mediated by particulate matter, temperature, and physical activity, yielding a total indirect effect of 0.826 (95 % CI: 0.769, 0.887) for each IQR increase in greenness exposure. Notably, the protective effect of greenness against lung cancer mortality could be achieved primarily by reducing the particulate matter concentration.

[Acupotomy relieves pain and improves motor function by regulating autophagy and apoptosis of cartilage in rabbits with knee osteoarthritis apoptosis].

OBJECTIVE: To observe the effect of acupotomy on the expression of Beclin-1, Bcl-2 and Caspase-3 in the cartilage tissue in rabbits with knee osteoarthritis (KOA), so as to explore its mechanism underling improvement of KOA. METHODS: Twenty-four healthy male New Zealand rabbits were randomly and equally divided into blank control, model and acupotomy groups, with 8 rabbits in each group. By using the modified Videman's methods, the KOA model was established by left hind limb immobilization with a plaster cast for 6 weeks. The severity of KOA (knee pain, swelling and motor function) was assessed using Lequesne score, and the rabbits with a score below 4 were excluded. The acupotomy was applied to "Hedingci" (the attachment of the quadriceps tendon to the patella at the upper edge), "Binneixia" (the medial patellar supporting band attachment of medial inferior patellar margin), "Binwaixia" (the lateral patellar supporting band attachment of the lower lateral patellar margin), "Chengfeijian" (the lateral collateral ligament of the knee passes over the lateral joint space), "Weiyangci" (the medial margin of biceps femoris at the lateral end of popliteus), "Yinlingci" (the medial tibial attachment of anserinus tendon) on the left hind limb once a week for 4 weeks. One week after the last intervention, the left knee joint dysfunction severity(pain, maximum walking distance, and some activities of daily living) was evaluated by using modified Lequesne score. Histopathological changes of the cartilage were observed under light microscope after H.E. staining. The apoptosis of chondrocytes was observed after terminal deoxynucleotidyl transferase-mediated fluorescein-dUTP nick-end labeling (TUNEL) staining. The autophagolysosomes of chondrocytes were observed using transmission electron microscopy. The expression levels of Beclin-1, Bcl-2 and Caspase-3 (related factors of autophagy and apoptosis) were detected using Real-time PCR and Western blot separately. RESULTS: In comparison with the blank control group, the Lequesne score, apoptosis rate, expression levels of Caspase-3 mRNA and protein were significantly increased (P<0.001), and the number of autophagolysosomes, expression levels of Beclin-1 and Bcl-2 mRNAs and proteins considerably decreased (P<0.001) in the model group. Relevant to the model group, the acupotomy group had an obvious decrease in Lequesne score, rate of apoptosis, and expression levels of Caspase-3 mRNA and protein (P<0.001) and an apparent increase in the number of autophagolysosomes and expression levels of Beclin-1 and Bcl-2 mRNAs and proteins (P<0.001). Findings of H.E. staining showed severe damaged cartilage surface, with a large number of exfoliation defects, few chondrocytes on the surface and disordered arrangement of transitional cells in the model group, which was relatively milder in the acupotomy group. CONCLUSION: Acupotomy can mitigate knee-joint pain and improve functional activity in KOA rabbits, which may be associated with its functions in promoting autophagy and suppressing apoptosis by up-regulating expressions of Beclin-1 and Bcl-2 mRNAs and proteins and down-regulation of Caspase-3 mRNA and protein.

The mediating effect of engagement in physical activity over a 24-hour period on chronic disease and depression: Using compositional mediation model.

BACKGROUND: Popular mediation method only considers a single activity as a mediator instead of all 24-hour physical activity, such as a four-way decomposition method. We investigated the mediation of 24-hour movement continuum between chronic diseases (cardiovascular disease [CVD] and diabetes) and depression using a novel compositional mediation model. METHODS: 24-hour activity data measured by accelerometer were obtained from NHANES 2005-2006. Adjusted coefficient with 95% confidence interval (95% CI) for PHQ-9 total score and adjusted odds ratio (OR) with 95% CI for depression were computed from compositional mediation models. RESULTS: In total, 2,375 participants aged ≥ 20 were included in our analysis. Both diabetes and CVD were associated with increased sedentary behavior (SB) and sleep and reduced moderate-to-vigorous physical activity (MVPA) and light-intensity physical activity (LPA), leading to an increased likelihood of depression. Although not all component indirect effects were associated with PHQ-9 total score and depression, the total indirect effect was significantly associated with both PHQ-9 total score (coefficient (95% CI) for diabetes: 0.162 (0.081, 0.261); coefficient (95% CI) for CVD: 1.139 (1.061, 1.240)) and depression (OR (95% CI) for diabetes: 0.235 (0.126, 0.362); OR (95% CI) for CVD: 1.200 (1.088, 1.346)) using the compositional mediation model. CONCLUSION: We developed a compositional mediation model for continuous and binary outcomes, which can handle entire compositional mediators as a unit. The mediation of 24-hour movement continuum mediated the association between diabetes, CVD, and depression. Our findings present potential interventions for reducing risk of depression among patients with CVD and diabetes.

Teacher respiratory health symptoms in relation to school and home environment.

PURPOSE: Few studies have evaluated teachers' respiratory health, especially its relationship with school/home environment, and school policies. This study assessed asthma and smoking prevalence among teachers in Romania, teacher's perception and knowledge of the school environment, policies and asthma management, and how school and home environment affected asthma, allergy, and respiratory infection symptoms. METHODS: This cross-sectional study obtained information from 104 Romanian teachers utilizing teacher questionnaire data for Romania only, as part of the Schools Indoor Pollution and Health: Observatory Network in Europe (SINPHONIE) study, a multicenter European research project conducted between 2010 and 2012. The SINPHONIE questionnaire collected comprehensive information on school and home environment, respiratory symptoms, smoking, and school policies. We used unconditional logistic regression analysis to examine environment-outcome relationships while controlling for socio-demographics and co-exposures. RESULTS: Our results showed the prevalence of asthma-like symptoms and smoking among teachers in Romania was higher than in other SINPHONIE schools and among US teachers. Factors statistically associated with asthma, allergy, and respiratory infection (all p < 0.05) include perception of health related to poor air quality in school, inappropriate cleaning of ventilation systems, dwelling proximity to busy traffic, and multiple school/home exposures. We also found lack of asthma management and environmental policies in the investigated Romanian schools. CONCLUSION: We concluded that multiple school and home environmental factors were related to respiratory and allergic symptoms. High asthma burden and smoking are important public health problems in Romania. Future studies including larger sample size and exposure measurements are needed to confirm our findings.